Ng E S, Ting J R S, Foo S L, Akram S A, Fadzlina A A, Alywiah J S, Ahmad T Sara
Department of Orthopaedic Surgery, University Malaya Medical Centre, 50603 Kuala Lumpur, Malaysia.
Med J Malaysia. 2006 Dec;61 Suppl B:23-6.
The conventional upper arm tourniquet used for hand and wrist operations may cause significant discomfort to patient when the procedure is performed under local anaesthesia. Forearm tourniquet causes less muscle ischeamia and pain. The discomfort experienced while using a forearm and upper arm tourniquet was assessed in 96 healthy subjects. Tourniquet placed on both sides was inflated sequentially to 250mmhg for five minutes on different hand. The discomfort level was assessed using a small visual analogue scale and complications were recorded. In the upper arm tourniquet, 24.9% had mild, 60.5% had moderate and 14.6% had severe pain whereas with forearm tourniquet, 99% had mild pain and only 1% had moderate pain. Seventy-nine percent of the subjects tested with forearm tourniquet had no discomfort at all. The average discomfort level for upper arm and forearm tourniquet was 4.72 and 0.39 respectively, which is statistically significant. Complications that were observed only in upper arm tourniquet included prolonged tingling, burning sensation and discomfort and stiffness of the upper limb. We concluded that forearm tourniquet was safe and well tolerated and should be used more often when indicated.
用于手部和腕部手术的传统上臂止血带在局部麻醉下进行手术时可能会给患者带来极大不适。前臂止血带导致的肌肉缺血和疼痛较少。对96名健康受试者使用前臂和上臂止血带时的不适情况进行了评估。在不同手上，将双侧放置的止血带依次充气至250毫米汞柱并维持5分钟。使用小型视觉模拟量表评估不适程度，并记录并发症情况。在上臂止血带组中，24.9%有轻度疼痛，60.5%有中度疼痛，14.6%有重度疼痛；而在前臂止血带组中，99%有轻度疼痛，只有1%有中度疼痛。接受前臂止血带测试的受试者中有79%完全没有不适。上臂和前臂止血带的平均不适程度分别为4.72和0.39，具有统计学意义。仅在上臂止血带组中观察到的并发症包括长时间的刺痛、烧灼感以及上肢的不适和僵硬。我们得出结论，前臂止血带安全且耐受性良好，在有指征时应更频繁地使用。
